Effects of vitamin E and C supplementation on oxidative stress and viral
load in HIV-infected subjects.
Allard JP; Aghdassi E; Chau J; Tam C; Kovacs CM; Salit IE; Walmsley
AIDS 1998 Sep 10;12(13):1653-9
OBJECTIVES: The HIV-infected population
is known to be oxidatively stressed and deficient in antioxidant micronutrients.
Since in vitro replication of HIV is increased with oxidative stress,
this study assessed the effect of antioxidant vitamin supplementation
on lipid peroxidation, a measure of oxidative stress, and viral load in
humans. DESIGN: A randomized placebo-controlled, double-blind study. METHODS:
Forty-nine HIV-positive patients were randomized to receive supplements
of both DL-alpha-tocopherol acetate (800 IU daily) and vitamin C (1000
mg daily), or matched placebo, for 3 months. Plasma antioxidant micronutrient
status, breath pentane output, plasma lipid peroxides, malondialdehyde
and viral load were measured at baseline and at 3 months. New or recurrent
infections for the 6-month period after study entry were also recorded.
RESULTS: The vitamin group (n = 26) had an increase in plasma concentrations
of alpha-tocopherol (P < 0.0005) and vitamin C (P < 0.005) and a
reduction in lipid peroxidation measured by breath pentane (P < 0.025),
plasma lipid peroxides (P < 0.01) and malondialdehyde (P < 0.0005)
when compared with controls (n = 23). There was also a trend towards a
reduction in viral load (mean +/- SD changes over 3 months, -0.45 +/-
0.39 versus +0.50 +/- 0.40 log10 copies/ml; P = 0.1; 95% confidence interval,
-0.21 to -2.14). The number of infections reported was nine in the vitamin
group and seven in the placebo group. CONCLUSION: Supplements
of vitamin E and C reduce oxidative stress in HIV and produce a trend
towards a reduction in viral load. This is worthy of larger clinical trials,
especially in HIV-infected persons who cannot afford new combination therapies.